mHealth Monthly Mashup: release 4.0 – how mHealth is revolutionizing emergency services

Michael Spitz

Ignite Health

Continued from “mHealth Monthly Mashup: release 3.0 – the role of non-profits in mHealth innovation”.

Well before the advent of tablets and smartphones, emergency physicians led the mHealth charge by utilizing suites of nascent software products from their PDAs, including drug interaction checkers, dosing calculators, and increasingly sophisticated diagnostic tools. The immediacy and urgency of their critical role in the emergency room accelerated the adoption of point of care mobile information technology, paving the way for more expansive mHealth uptake by medical specialists, primary care physicians, and even the general public.

“So let’s take a quick survey illustrating the depth and breadth of these mHealth innovations for emergency medicine and beyond…”

As mobile technology has exponentially evolved over the past 2 to 3 years, the value of these devices and the nearly instantaneous data they provide for healthcare professionals, first responders, and now patients has greatly increased. So let’s take a quick survey illustrating the depth and breadth of these mHealth innovations for emergency medicine and beyond, and discover how the latest hardware and software upgrades—including geolocation, advanced sensor, and EHR integration functionality—have revolutionized emergency care.

Error reduction

Pediatric dosing can prove challenging even under non-emergency situations, since numerous variables such as age, weight, height and other factors must be considered before administration. The emotionally charged and often chaotic circumstances of an emergency often interfere with a physician’s capacity for rapid, accurate, and complex dosing. An app such as the PICU Calculator has actually been proven to optimize these calculations and reduce errors during the prescription of vasopressors in simulated situations of shock.

As described by the informative mHealth resource iMedicalApps, comparison was made between physicians using the British National Formulary for Children reference tool and the PICU Calculator app from a smartphone. According to the study only 30% of providers using the BFNC were successful, whereas 100% of those using the mHealth app correctly dosed. Those physicians using the app also required significantly less time to calculate and dose, of critical importance during life-threatening emergencies.

Public safety

Most Americans know of the emergency broadcast system as a noisy, 30-second test over late night television and radio channels, engaged rarely but in the event of serious announcements such as natural disasters, terrorist attacks, or AMBER missing persons alerts. The near ubiquity of cell and smartphones—coupled with their capacity to be engaged regionally and even locally through geolocation technology—lend themselves to their fresh and potentially powerful utilization as a broadcast channel for public safety announcements.

So the American Federal Communications Commission (FCC) and Federal Emergency Management Agency (FEMA) have just this May announced a new emergency alert system for mobile phones in the Washington, DC and New York City areas called “Personal Localized Alerting Network,” or PLAN. Consumers using cell or smartphones from the four major carriers will be able to receive a free text message alerting them to local emergencies, communicated directly to the mobile devices of populations immediately impacted.

Personal emergency response

Nearly 300,000 people die from sudden cardiac arrest in the United States alone, many of these deaths preventable with rapidly administered CPR or defibrillation. The signs of crisis, including rapid change in heart rate, blood pressure, and bodily motion can all now be unobtrusively monitored and shared in real time using mobile technology. The “Wriskwatch” from Emergency Medical Technologies has been proven effective doing just that, an example of how mHealth can become an extension of telemedicine, potentially saving countless lives.

“…the unit and those like it usher in a new era of personal mHealth diagnostics, where high risk patients remain effortlessly and constantly connected to emergency services…”

The device looks and feels like a regular wristwatch, with sensors that detect loss of radial pulse and immediately contacts nearby emergency medical systems should its wearer communicate the likelihood of a cardiac emergency. Although not yet approved by the FDA, the unit and those like it usher in a new era of personal mHealth diagnostics, where high risk patients remain effortlessly and constantly connected to emergency services as if they were being watched round the clock in a hospital or even emergency room.

Medical device wristwatch

Crowdsourcing emergency response

Too often people die from cardiac arrest within a few short miles or less of someone who knows CPR. How can the right emergency message get to the right responder at the right time? Enter an mHealth app that utilizes geolocation and emergency communication integration to alert someone trained in CPR within the immediate proximity of a cardiac arrest victim. An iPhone app created by interns at North Kentucky University Center for Applied Informatics does exactly that, as featured in an interesting TechCrunch article.

The app is triggered when the local 911 emergency center receives a call. The experienced CPR person nearby in turn receives an alert, checks their smartphone app, and is guided to the GPS coordinates of the cardiac arrest victim where help can be quickly administered. Extending the utility of such an app to everything from poisoning to allergic reactions to stroke and into the realm of EMS is intriguing, privacy and accountability concerns abound as they always do with this kind of information, but mHealth has clearly opened the door to a world of possibility, beckoning local and national providers to offer similar solutions.

QR codes and emergency response

“Quick Response” or QR codes bridge the gap between offline and online worlds by enabling smartphone users to rapidly scan a barcode-like image and immediately connect to digital content, whether a website, graphical image, or, in the case of this mHealth tool, vitally important medical information. As reported by Yahoo Finance, the MedFlash Personal Health &amp, Wellness Management service uses these QR codes to enable members’ personal health records to be accessed instantly by first responders in the case of an emergency.

“Should an emergency happen, first responders are able to scan the code and instantly gain access to the patient’s personal health information…”

Members of the service carry a health card upon which is printed their unique QR code. Should an emergency happen, first responders are able to scan the code and instantly gain access to the patient’s personal health information, revealing everything from medical history to allergies to current prescription and potential drug interactions. Privacy and legal concerns notwithstanding, the value of such functionality for the at-risk and even general population is significant, revealing yet again the potential of mHealth for saving lives.

The future mEmergencyHealth

A combination of emergency expertise, evolving technology, and a shifting health record privacy landscape has brought mHealth into the forefront of emergency alerts and response. As mobile devices and their peripherals become increasing miniaturized and complex, the boundary between the patient, their information, and emergency assistance begins to vanish, thereby reducing the time to treat, heightening efficiencies, and increasing the likelihood of favourable outcomes.

Part 5 of this series can be viewed here.

About the author:

Michael Spitz is VP of Digital Strategy at Ignite Health, with offices located in New York City, New York, and Irvine, California. Spitz combines his passion for technology with more than 15 years of clinical content expertise to help engineer healthcare communications solutions across numerous treatment areas for many of the pharmaceutical industry’s major companies. Follow @SpitzStrategy on Twitter for his daily – often hourly – updates on all things digital for the ultimate benefit of patients worldwide.

How might mHealth tools for emergency response benefit HCPs and patients?